1/4. Severe obstructive sleep apnoea secondary to pressure garments used in the treatment of hypertrophic burn scars.Obstructive sleep apnoea (OSA) secondary to pressure garments used to treat hypertrophic scarring of burns has never been reported. The present study describes two children who presented with OSA following introduction of such garments for management of hypertrophic scars following severe facial and upper body burns. Complex sleep polysomnography confirmed severe OSA with desaturations sufficient to result in physiological dysfunction that significantly improved on removal of the garments. As there is little evidence to suggest that the use of such garments alters the end result, the potentially serious side effect of obstructive sleep apnoea should be considered before their use is advised.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/4. Effect of facial pressure garments for burn injury in adult patients after orthodontic treatment.pressure garments are commonly used to prevent and control hypertrophic scar tissue. Complications are unusual, though in children with facial burns, pressure garments may lead to skeletal and dental deformities. Studies in adolescents and adults are sparse. We describe a 24-year-old woman who sustained facial burns. Prior to injury, the patient had undergone premolar extraction in preparation for orthodontic treatment. Her post-burn care consisted of application of a Jobst pressure garment. After 2 months treatment, severe deformation of the dental-alveolar structure was observed. This reports suggests that adults after dental extraction are at a high risk of dental-alveolar deformities from pressure garments and might benefit from the use of occlusal wafers.- - - - - - - - - - ranking = 1.4keywords = pressure (Clic here for more details about this article) |
3/4. Refinements of medial plantar flap used for covering nonweightbearing ankle and posterior heel defects requiring thin flaps.We present our clinical experiences with the refinements that we applied to avoid circular flap contraction and achieve thin flap coverage in the reconstruction of posterior heel and tendocalcaneal skin defects with medial plantar flap. Eight male patients, aged 18 to 35 (mean 24 years), with nonweightbearing skin defects, were treated with refined medial plantar flaps. All flaps survived and no circulation problem was encountered. The flaps adapted well to the recipient area, and thin and well-contoured skin coverage was achieved by postoperative month 6. As a conclusion, it is possible to reconstruct the nonweightbearing defects needing thin flap by medial plantar flap with adding refinements: (1) adding triangles around the flap, (2) harvesting a thin flap by excluding the thick plantar fascia, (3) harvesting a further thin flap by defatting of the flap, (4) application of pressure to the flap.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
4/4. Silicone gel sheeting for the prevention and management of evolving hypertrophic and keloid scars.BACKGROUND. Hypertrophic scars and keloids remain a problem for surgeons. Topical and intralesional corticosteroids, positive pressure dressings, cryotherapy, and laser therapy are helpful but not uniformly successful. OBJECTIVE. To document the effectiveness of silicone gel sheeting in the prevention and/or reduction of evolving hypertrophic scars and keloids. methods. Silicone gel sheeting was placed over evolving scars in 20 cases. The dressing was worn for at least 12 hours a day. Biopsies were examined for the presence of silica in the tissue. RESULTS. Lesions improved during the treatment period in 85% of the cases. The mechanisms of action are unknown. Positive pressure was not necessary. No silica from the dressing was found at the wound site. CONCLUSION. Daily treatments with silicone gel sheeting should begin as soon as an itchy red streak develops in a maturing wound. The dressing is effective in reducing the bulk of these lesions.- - - - - - - - - - ranking = 0.4keywords = pressure (Clic here for more details about this article) |